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Articles and blogs 

March 20, 2024 · Public Policy & Regulatory Affairs Team
Several states update their medical fee schedules, while others propose updates; workers’ comp PTSD and mental health coverage bills pending in many states; expanded cancer coverage likely in Maryland; Florida significantly increases physician reimbursement; Montana clarifies workers’ comp rules; and Texas looks to improve the provider complaint process. Read more...
March 11, 2024 · Medicare Insights Team
CMS will update MIR steps RREs must take in reporting Medicare workers compensation TPOCs claims and notifying CMS of WCMSA arrangements. Read more...
March 07, 2024 · Public Policy & Regulatory Affairs Team
AAPAN VP for Government Affairs Lisa Anne Hurt-Forsyth chats with the Policy Guys about how AAPAN engages with state lawmakers and administrators to develop, debate, and deliver meaningful and effective workers’ comp policies. Read more...
March 04, 2024 · Public Policy & Regulatory Affairs Team
The California Division of Workers’ Compensation (DWC) proposed significant rule changes in the final phase of integrating its workers’ comp pharmacy reimbursement process into the state’s Medicaid (“Medi-Cal”) pharmacy reimbursement structure. Read more...
February 28, 2024 · Public Policy & Regulatory Affairs Team
California corrects drug formulary, Kentucky introduces several work comp bills, Wisconsin bill would establish a work comp medical fee schedule, New York enhances prior auth portal, several other states introduce work comp firefighter coverage and presumption bills, and New Mexico eyes study on treatment with mushrooms Read more...
January 29, 2024 · Medicare Insights Team
Recent CMS webinar clarifies final rule on civil money penalties for Non-Group Health Plans, describing the triggers for reporting and the auditing process, emphasizing that RREs are required to report claims and that the penalties apply only to prospective claims, and distinguishing between informal and formal notices. Read more...
January 18, 2024 · By: Courtney DuChene, Risk & Insurance
One way workers’ comp and auto no-fault payers can ensure that their patients are getting the best care possible is by partnering with a PBM that works with pharmacists from a wide array of clinical backgrounds Read more...
January 17, 2024 · Clinical Team
The U.S. Food and Drug Administration (FDA) reported that Dr. Reddy’s voluntarily recalled one lot of tizanidine 4 mg tablets at the consumer level as a precautionary measure. Tizanidine is a skeletal muscle relaxant commonly prescribed for the treatment of muscle spasticity. Read more...
December 07, 2023 · Public Policy & Regulatory Affairs Team
The Policy Guys are back at it, yet again. In this episode, the Guys mix metaphors and swap dad jokes with Michael Flower, Optum Associate General Counsel and resident guru on Medicare set-asides to help explain the latest CMS rule changes, specifically the requirements for claimants, as well as the penalties and fines for claims that fail to meet those requirements. Read more...
December 06, 2023 · Clinical Team
FDA warns that the antiseizure medications levetiracetam and clobazam may cause life-threatening adverse reaction. Read more...
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